Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014
Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT.
СтатьяРандомизированное исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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van Dijk J D, Jager P L, Mouden M, Slump C H, Ottervanger J P, de Boer J, Oostdijk A H J, van Dalen J A
Аннотация
BACKGROUND: Guidelines for SPECT myocardial perfusion imaging (MPI) traditionally recommend a fixed tracer dose. Yet, clinical practice shows degraded image quality in heavier patients. The aim was to optimize and validate the tracer dose and scan time to obtain a constant image quality less dependent on patients' physical characteristics.
METHODS: 125 patients underwent Cadmium Zinc Telluride (CZT)-SPECT stress MPI using a fixed Tc-99m-tetrofosmin tracer dose. Image quality was scored by three physicians on a 4-point grading scale and related to the number of photon counts normalized to tracer dose and scan time. Counts were correlated with various patient-specific parameters dealing with patient size and weight to find the best predicting parameter. From these data, a formula to provide constant image quality was derived, and subsequently tested in 92 new patients.
RESULTS: Degradation in image quality and photon counts was observed for heavier patients for all patients' specific parameters (P < .01). We found body weight to be the best-predicting parameter for image quality and derived a new dose formula. After applying this new body weight-depended tracer dose and scan time in a new group, image quality was found to be constant (P > .19) in all patients.
CONCLUSIONS: Also in CZT SPECT image quality decreases with weight. The use of a tracer dose and scan time that depends linearly on patient's body weight corrected for the varying image quality in CZT-SPECT MPI. This leads to better radiation exposure justification.
METHODS: 125 patients underwent Cadmium Zinc Telluride (CZT)-SPECT stress MPI using a fixed Tc-99m-tetrofosmin tracer dose. Image quality was scored by three physicians on a 4-point grading scale and related to the number of photon counts normalized to tracer dose and scan time. Counts were correlated with various patient-specific parameters dealing with patient size and weight to find the best predicting parameter. From these data, a formula to provide constant image quality was derived, and subsequently tested in 92 new patients.
RESULTS: Degradation in image quality and photon counts was observed for heavier patients for all patients' specific parameters (P < .01). We found body weight to be the best-predicting parameter for image quality and derived a new dose formula. After applying this new body weight-depended tracer dose and scan time in a new group, image quality was found to be constant (P > .19) in all patients.
CONCLUSIONS: Also in CZT SPECT image quality decreases with weight. The use of a tracer dose and scan time that depends linearly on patient's body weight corrected for the varying image quality in CZT-SPECT MPI. This leads to better radiation exposure justification.
Предметные рубрики MeSH
Body SizeCadmiumFemaleHumansImage Interpretation, Computer-AssistedMaleMaximum Tolerated DoseMiddle AgedMyocardial Perfusion ImagingObserver VariationOrganophosphorus CompoundsOrganotechnetium CompoundsPatient SafetyRadiation DosageRadiation ProtectionRadiopharmaceuticalsReproducibility of ResultsSensitivity and SpecificityTelluriumTomography, Emission-Computed, Single-PhotonWhole-Body CountingZinc